MRI of Acute Spinal Epidural Hematomas

Abstract

The purpose of this work was to determine the MR findings that characterize acute spinal epidural hematomas (ASEHs). The MR findings of 17 patients with ASEH (9 cervical, 7 thoracic, and 2 lumbar) were reviewed. Fifteen of the hematomas were secondary to trauma and two were spontaneous. Correlation with CT (8 cases) and surgical findings (11 cases) was also performed. Imaging findings in ASEH were the following: (a) a variable signal intensity (on T1-weighted images, 10 showed isointensity to cord and 7 were slightly hyperintense; T2-weighted images showed hyperintensity with areas of hypointensity); (b) capping of epidural fat; (c) direct continuity with the adjacent osseous structures; (d) compression of epidural fat, subarachnoid sac, and spinal cord; (e) usually posterolateral location in the spinal canal. Epidural hematomas in the spinal canal are lesions capable of producing sudden spinal cord and/or cauda equina compression. MR provides characteristic findings that allow a prompt diagnosis of acute epidural hematomas.